Department of Neurosurgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Department of Radiology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Ann Nucl Med. 2020 Jul;34(7):467-475. doi: 10.1007/s12149-020-01473-8. Epub 2020 May 6.
To investigate the characteristics of patients with moyamoya disease (MMD) who show improvement in their cognitive decline after bypass surgery by analyzing the hemodynamic and metabolic parameters of O-gas positron emission tomography (PET).
We retrospectively analyzed adult patients with MMD who were evaluated with PET and cognitive tests before and approximately one year after indirect bypass surgery. The PET parameters of the left Rolandic area were compared between patients who did and did not show improvement in their cognitive decline.
Of the 19 patients analyzed, fourteen (74%) showed improvement in either the verbal or performance intelligence quotient (VIQ or PIQ). Three out of four patients with perioperative infarction experienced significant cognitive decline. The preoperative oxygen extraction fraction (OEF) was significantly higher in patients who showed improvement in their cognitive decline in terms of the PIQ than in those patients who did not (P = 0.03). The postoperative increase in the cerebral metabolic rate of oxygen (CMRO) was significantly higher in patients who showed improvement in their cognitive decline in terms of the VIQ than in those who did not (P = 0.02).
Adult patients with MMD might show improvement in their cognitive decline after successful indirect bypass surgery if they have a severely increased regional OEF before the surgery and an increased regional CMRO after the surgery.
URL: https://www.umin.ac.jp/ctr/. Unique identifier: UMIN000027949.
通过分析氧-15 正电子发射断层扫描（O-gas PET）的血流动力学和代谢参数，研究搭桥手术后认知功能下降改善的烟雾病（MMD）患者的特点。
我们回顾性分析了接受 PET 和认知测试的成年 MMD 患者，这些患者在间接搭桥手术前和大约一年后进行了评估。比较了认知功能下降改善和未改善的患者左 Rolandic 区的 PET 参数。
在 19 名分析的患者中，14 名（74%）患者的言语或操作智商（VIQ 或 PIQ）有所改善。4 例围手术期梗死患者中有 3 例认知功能明显下降。PIQ 认知功能下降改善的患者术前氧摄取分数（OEF）明显高于未改善的患者（P=0.03）。VIQ 认知功能下降改善的患者术后氧代谢率（CMRO）增加明显高于未改善的患者（P=0.02）。
如果成年 MMD 患者在手术前区域 OEF 严重升高，手术后区域 CMRO 增加，他们可能会在间接搭桥手术后改善认知功能下降。
